The effect of community nurses and health volunteers on child mortality: The Navrongo Community Health and Family Planning Project

Pence, Brian W.; Nyarko, Philomena; Phillips, James F.; Debpuur, Cornelius

doi:10.1080/14034940701349225

Cited by 42 publications

(18 citation statements)

References 25 publications

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Section: Resultsmentioning

confidence: 99%

Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review

Gogia

Sachdev

2016

J Perinatol

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The objective of this review is to assess the effect of home-based neonatal care provided by community health workers (CHWs) for preventing neonatal, infant and perinatal mortality in resource-limited settings with poor access to health facility-based care. The authors conducted a systematic review, including meta-analysis and meta-regression of controlled trials. The data sources included electronic databases, with a hand search of reviews, abstracts and proceedings of conferences to search for randomized, or cluster randomized, controlled trials evaluating the effect of home-based neonatal care provided by CHWs for preventing neonatal, infant and perinatal mortality. Among the included trials, all from South Asian countries, information on neonatal, infant and perinatal mortality was available in five, one and three trials, respectively. The intervention package comprised three components, namely, home visits during pregnancy (four trials), home-based preventive and/or curative neonatal care (all trials) and community mobilization efforts (four trials). Intervention was associated with a reduced risk of mortality during the neonatal (random effects model relative risk (RR) 0.75; 95% confidence intervals (CIs) 0.61 to 0.92, P=0.005; I2=82.2%, P<0.001 for heterogeneity; high-quality evidence) and perinatal periods (random effects model RR 0.78; 95% CI 0.64 to 0.94, P=0.009; I2=79.6%, P=0.007 for heterogeneity; high-quality evidence). In one trial, a significant decline in infant mortality (RR 0.85; 95% CI 0.77 to 0.94) was documented. Subgroup and meta-regression analyses suggested a greater effect with a higher baseline neonatal mortality rate. The authors concluded that home-based neonatal care is associated with a reduction in neonatal and perinatal mortality in South Asian settings with high neonatal-mortality rates and poor access to health facility-based care. Adoption of a policy of home-based neonatal care provided by CHWs is justified in such settings.

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Section: Resultsmentioning

confidence: 99%

Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review

Gogia

Sachdev

2016

J Perinatol

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“…One study compared the effects of introducing village-based community nurse services versus a participation intervention (village health committees plus community health volunteers) alone, or nurse services and participation combined [49]. Unfortunately they do not report on newborn outcomes directly, although they found that infant mortality was higher in the two participation areas (where it was introduced alone and also where it was combined with the nurse services), and only reduced in the areas with nurse services alone, suggesting that, in this case, the health committees and community volunteers may even have had a detrimental effect.…”

Section: Resultsmentioning

confidence: 99%

Effects of Community Participation on Improving Uptake of Skilled Care for Maternal and Newborn Health: A Systematic Review

et al. 2013

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BackgroundDespite a broad consensus that communities should be actively involved in improving their own health, evidence for the effect of community participation on specific health outcomes is limited. We examine the effectiveness of community participation interventions in maternal and newborn health, asking: did participation improve outcomes? We also look at how the impact of community participation has been assessed, particularly through randomised controlled trials, and make recommendations for future research. We highlight the importance of qualitative investigation, suggesting key areas for qualitative data reporting alongside quantitative work.Methods and findingsSystematic review of published and ‘grey’ literature from 1990. We searched 11 databases, and followed up secondary references. Main outcome measures were the use of skilled care before/during/after birth and maternal/newborn mortality/morbidity. We included qualitative and quantitative studies from any country, and used a community participation theoretical framework to analyse the data. We found 10 interventions. Community participation had largely positive impacts on maternal/newborn health as part of a package of interventions, although not necessarily on uptake of skilled care. Interventions improving mortality or use of skilled care raised awareness, encouraged dialogue and involved communities in designing solutions–but so did those showing no effect.DiscussionThere are few high-quality, quantitative studies. We also lack information about why participation interventions do/do not succeed – an area of obvious interest for programme designers. Qualitative investigation can help fill this information gap and should be at the heart of future quantitative research examining participation interventions – in maternal/newborn health, and more widely. This review illustrates the need for qualitative investigation alongside RCTs and other quantitative studies to understand complex interventions in context, describe predicted and unforeseen impacts, assess potential for generalisability, and capture the less easily measurable social/political effects of encouraging participation.

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“…Children born in the three northern regions (Northern, Upper East and Upper West) had better chances of being registered. Although it is difficult to tease out specific factors contributing to this observation, it seems that the Community Health Services Programme (CHPS) [20], which has operated in the northern regions longer than in other areas might be contributing to improvements in child registration. CHPS seeks to promote maternal and child health particularly targeting people in deprived communities.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic determinants of birth registration in Ghana

Amo-Adjei

Annim

2015

BMC Int Health Hum Rights

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BackgroundIdentity registration is not only a matter of human rights but it also serves as an important instrument for planning about health, education and overall development. This paper examines the chances of a child born in Ghana between 2001 and 2006 obtaining legal status of identity.MethodsData for this paper were extracted from the 2006 Ghana Multiple Indicator Cluster Survey (MICS). We used discrete choice modelling in estimating the likelihood of child registration in Ghana.ResultsMother’s education and household wealth are identified to be positively associated with the likelihood of a child being registered. In the context of structural factors, being a resident in the Eastern region of Ghana and rural areas were found to be risk factors for children not being registered. Besides, children who were resident in households where the head is affiliated to Traditional Religion were found to be at significant risk of being unregistered.ConclusionOverall, our findings give an impression of birth registration being a privilege for children whose parents are educated, wealthy and resident in urban communities. Policies meant to increase uptake have to be broad-based, targeting the less privileged particularly with practical interventions such as transport vouchers to registration centres. This may help appropriate meaning to international protocols on birth registration as a human right issue to which Ghana affirms.

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The effect of community nurses and health volunteers on child mortality: The Navrongo Community Health and Family Planning Project

Abstract: These results suggest that convenient, accessible professional nursing care can reduce child mortality in impoverished African settings. However, they do not demonstrate a beneficial effect of community volunteers and suggest a possible negative impact on children's survival.

Cited by 42 publications

References 25 publications

Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review

Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review

Effects of Community Participation on Improving Uptake of Skilled Care for Maternal and Newborn Health: A Systematic Review

Socioeconomic determinants of birth registration in Ghana

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